Question: do you measure Hcy in your patients to get an idea of their nutritional status AND some of their genetic impediments [if you don’t suggest to them it may be wise to take a no-iron multivitamin/mineral pill]?

To PC: $0.13/pill vs $3.45 for Crestor .. The WHO reported the lowest world retail price of $4.99/YEAR supply or $0.013/day. If only they would save people.
Whatever the heart attack epidemic that started with Herrick’s 1912 JAMA article [great reading] was caused by, it was not the lack of circulating statins. Cheaper is not better. Hope springs eternal but fear [of terrorists, communists, cholesterol] is what motivates people, however little science-based.

EddieVos,
The Lyon diet heart study didn’t use canola or flax seed oil. It was a study with a Mediterranean diet. You are trying to say using the oils themselves or vitamins will do the job. That has not been studied. The diet has been studied and I have no problems with it. Regarding Hcy, the studies are not convincing. Sorry.

Did you actually read that whole editorial??
I did the blood fatty acid re-analysis and the ONLY difference >+/-10% was a +160% in ALA and +60% in ALA derived EPA.
Moreover, redoing the ‘diet’ analysis, and I did, there were NO significant changes and trust me, Frenchmen would not voluntarily deviate from a happy food habit. What they DID do was accept free non hydrogenated canola oil margarine supplied free for the entire family.

It became a “diet” study only to get it published [but it is true that the 2 senior authors, superb but hard headed men, split up scientifically over that switch in emphasis]. NEMJ refused it because the cholesterol did not change [nada, zero, zip], i.e. something must be wrong with the study to be able to report such massive benefit in such small post MI group.
Lancet took it with some modifications of emphasis, and then there was follow-up stuff later in Circ. with that editorial.
Dismissing health benefit results resulting from only one (1) study supplied intervention, a benefit in deaths never seen before, and backed up by all of Leaf’s work is bizarre. That is not science, dismissing THE best results ever in preventing second MI’s and deaths. Being a skeptic I respect but dismissing results numerically 20x better than found in ANY statin trial is not serious.
Incidentally, Lyon does not and never did consume a “Mediterranean diet”, it being an industrial city closer to Paris. Then there are other studies re ALA but nothing will apparently convince you away from an opinion once expressed. Then again, we agree on ALA rich walnuts.

I don’t know about those Frenchmen. Did they give up their red wine? I read the circulation article and it did not talk about using supplements just the Mediterranean diet. The other link you provided is broken.

Sorry about that link: it’s section 1 in http://www.health-heart.org/comments.htm
I live in French Canada where there are some European French and I spent some time in France [and know the 2 main LYON authors], so I can affirm they would NOT change their happy diet in a fundamental way, ever, or indeed give up their red wine. The senior author, Renaud, had a statue erected in his honour by the Califronia wine growers for the work he did in wine –after he had worked at the Montreal Heart Institute and did massive original on-the-ground heart research in France.
Lyon has famed medical facilities.The only problem with red wine is that it does not go well with fatty omega-3 rich fish … unless of course you’ve run out of white wine first!

The inherent nature of a fatty acid trial [unless you use pills] is that it is high caloric and you thus have to remove something else by definition [butter with margarine in LYON] thereby introducing an unavoidable confounder.
Trust me, I’ve seen ‘diet’ trials galore and no dietary change promoted in repeat sessions by dietitians has ever saved a human. [recently the Women’s initiative with reduced fat intake and zip benefit]
GISSI used fish oil pills with similar results to LYON in secondary prevention. Cheers, Eddie

This website did not take my response in French which said: ‘no comment [re taste] and both are good for health, but only salmon has omega-3; tuna is a poor source of n-3 [the French was more elegant, e.